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Open Access 01-09-2018 | Clinical Study

Earliest radiological progression in glioblastoma by multidisciplinary consensus review

Authors: Roelant S. Eijgelaar, Anna M. E. Bruynzeel, Frank J. Lagerwaard, Domenique M. J. Müller, Freek R. Teunissen, Frederik Barkhof, Marcel van Herk, Philip C. De Witt Hamer, Marnix G. Witte

Published in: Journal of Neuro-Oncology | Issue 3/2018

Abstract

Background

Detection of glioblastoma progression is important for clinical decision-making on cessation or initiation of therapy, for enrollment in clinical trials, and for response measurement in time and location. The RANO-criteria are considered standard for the timing of progression. To evaluate local treatment, we aim to find the most accurate progression location. We determined the differences in progression free survival (PFS) and in tumor volumes at progression (Vprog) by three definitions of progression.

Methods

In a consecutive cohort of 73 patients with newly-diagnosed glioblastoma between 1/1/2012 and 31/12/2013, progression was established according to three definitions. We determined (1) earliest radiological progression (ERP) by retrospective multidisciplinary consensus review using all available imaging and follow-up, (2) clinical practice progression (CPP) from multidisciplinary tumor board conclusions, and (3) progression by the RANO-criteria.

Results

ERP was established in 63 (86%), CPP in 64 (88%), RANO progression in 42 (58%). Of the 63 patients who had died, 37 (59%) did with prior RANO-progression, compared to 57 (90%) for both ERP and CPP. The median overall survival was 15.3 months. The median PFS was 8.8 months for ERP, 9.5 months for CPP, and 11.8 months for RANO. The PFS by ERP was shorter than CPP (HR 0.57, 95% CI 0.38–0.84, p = 0.004) and RANO-progression (HR 0.29, 95% CI 0.19–0.43, p < 0.001). The Vprog were significantly smaller for ERP (median 8.8 mL), than for CPP (17 mL) and RANO (22 mL).

Conclusion

PFS and Vprog vary considerably between progression definitions. Earliest radiological progression by retrospective consensus review should be considered to accurately localize progression and to address confounding of lead time bias in clinical trial enrollment.

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Title: Earliest radiological progression in glioblastoma by multidisciplinary consensus review
Authors: Roelant S. Eijgelaar
Anna M. E. Bruynzeel
Frank J. Lagerwaard
Domenique M. J. Müller
Freek R. Teunissen
Frederik Barkhof
Marcel van Herk
Philip C. De Witt Hamer
Marnix G. Witte
Publication date: 01-09-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2896-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Earliest radiological progression in glioblastoma by multidisciplinary consensus review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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